France

Healthcare System

Universal public healthcare in France is one of the branches of the system of Social Security System for Salaried Workers. Each citizen must pay for compulsory health insurance, and each doctor or dentist's fee is reimbursed partially or fully to the citizen. The system is managed by the Caisse Nationale de l'Assurance Maladie (CNAM). The CNAM, along with the Health Data Hub, also manages the Système National des Données de Santé (SNDS), France's national health data system, in which the following information can be found: health insurance data (Sniiram), hospital-discharge data (PMSI), medical causes of death databases (CépiDc de l’Inserm) and disability data (CNSA). Any request to access data from the SNDS can be made to the Health Data Hub.

Administrative or Claims Data

SNIIRAM

[1]

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: All health care expenses, including outpatient visits, dispensed medication, procedures, chronic conditions, hospital admission diagnoses and procedures, date of death, date and nature of lab tests without results, as well as other information.

Source of Information: Includes data from 3 main claims systems (CNAMTS, RSI, and MSA) and almost all the smaller systems.

Data level: Patient level.

Number of Records: 98.8% of the French population as of 2017.

Date Range: 2003 onwards.

Information/Contact for data request: Instructions to access data.

Echantillon généraliste de bénéficiaires (EGB)

[1]

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Identical to SNIIRAM, but on a smaller scale to be more manageable. Data structure is streamlined and simplified in the EGB.

Source of Information: Includes data from 3 main claims systems (CNAMTS, RSI, and MSA) and almost all the smaller systems.

Data level: Patient level.

Number of Records: 1/97 random permanent sample from the SNIIRAM database.

Date Range: 2004 onwards.

PMSI

[1]

Sponsor, manager or home institution: Agence technique de l'information sur l'hospitalisation (ATIH) and Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Admission date, duration of stay, main, related, and associate diagnoses coded in ICD10 , hospital admissions for medical, surgical, and obstetrical wards, and other information. All of that information is for both public and private hospitals

Source of information: Recording of standardized medico-administrative data in a standard collection of information.

Data level: Patient level.

Number of Records: 98.8% of the French population as of 2017.

Information/Contact for data request: Instructions to access data.

Open Damir: Complete Database on Health Insurance Expenditure

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Six axes of analysis: period, benefit, care organization, care recipient, performing healthcare professional, prescribing health professional. Four amount indicators: total expenditure, health insurance reimbursement basis, amount reimbursed, excess fees for health professionals. Three volume indicators: enumeration, amount, coefficient.

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2009 to 2021.

Information/Contact for data request: The data is openly available.

National data on health insurance expenditure for community care

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Type of expense item, type of benefit (care and cash benefits), type of performer (doctors by specialty, dental surgeons, medical auxiliaries, analysis laboratories, pharmacists, etc.), type of prescriber, date of treatment, repayment rate, type of risk covered (sickness, maternity, accident at work and occupational disease). The expenditure indicators are: the reimbursement base of the Health Insurance, the amount reimbursed, excess fees for healthcare professionals, the count of acts performed and coefficients invoiced.

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2010 to 2022.

Information/Contact for data request: The data is openly available.

National health insurance expenditure data for private health facilities

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Department and region of residence of the beneficiary, type of expense item, type of service, type of establishment, establishment category, benefit discipline, date of treatment, repayment rate. The expenditure indicators are: the reimbursement base of the Health Insurance, the amount refunded.

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2009 to 2022

Information/Contact for data request: The data is openly available.

Data by CPAM on health insurance expenditure relating to city care

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Health insurance fund (CPAM), type of expense item, type of benefit (care and cash benefits), type of performer (doctors by specialty, dental surgeons, medical auxiliaries, analysis laboratories, pharmacists, etc.), type of prescriber, date of treatment, repayment rate, type of risk covered (illness, maternity, accident at work and occupational disease). The expenditure indicators are: the reimbursement base of the Health Insurance, the amount reimbursed, excess fees for healthcare professionals, the count of acts carried out and the coefficients invoiced.

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2010 to 2021

Information/Contact for data request: The data is openly available.

Data by CPAM on health insurance expenditure relating to private health establishments

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Health insurance fund (CPAM), department and region of residence of the beneficiary, type of expense item, type of service, type of establishment, establishment category, benefit discipline, date of treatment, repayment rate. The expenditure indicators are: the reimbursement base of the Health Insurance, the amount refunded.

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2010 to 2022

Information/Contact for data request: The data is openly available.

Open Medic: complete database on drug expenditure

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Main Anatomical Group, Therapeutic Subgroup, Pharmacological Subgroup, Chemical Subgroup, Chemical Subgroup, Pharmaceutical Specialty Identification Code, Top Generic, Generic Group, Age at the time of care, Sex, Region of Residence of the Beneficiary, Prescriber, Amount reimbursed, Refund Basis, Number of boxes delivered, Number of consumers (available only in NB_ type bases).

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2014 to 2021

Information/Contact for data request: The data is openly available.

Open Medic: additional databases on drug expenditure

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Main Anatomical Group, Therapeutic Subgroup, Pharmacological Subgroup, Chemical Subgroup, Chemical Subgroup, Pharmaceutical Specialty Identification Code, Top Generic, Generic Group, Age at the time of care, Sex, Region of Residence of the Beneficiary, Prescriber, Amount reimbursed, Refund Basis, Number of boxes delivered, Number of consumers (available only in NB_ type bases).

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2014 to 2021

Information/Contact for data request: [ https://assurance-maladie.ameli.fr/etudes-et-donnees/open-medic-depenses-beneficiaires-medicaments The data is openly available.]

Open PHMEV: complete database on hospital prescriptions for drugs delivered in the community

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Main Anatomical Group, Label ATC1, Therapeutic Subgroup, ATC2 label, Pharmacological Subgroup, ATC4 label, Chemical Subgroup, ATC3 label, Chemical Subgroup, ATC3 label, Label CIP13, Top Generic/Biosimilar/Princeps/Reference, Generic Group, Age range, Sex, Establishment Category, Region of establishment of the AP-HP and the Red Cross; Region of establishment of the managing establishment otherwise, Geographic Finess number for the AP-HP and the Red Cross; No legal Finess otherwise, Top establishment according to availability Age group: 0 no; 1 yes, Top establishment according to availability Gender: 0 no; 1 yes, Number of boxes, Amount reimbursed, Refundable Amount

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2014 to 2021

Information/Contact for data request: The data is openly available.

Open PHMEV: regional database on hospital prescriptions for drugs delivered in towns

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information:

Source of Information: Système National des Données de Santé (SNDS)

Data level:

Date Range: 2014 to 2021

Information/Contact for data request: The data is openly available.

Open Statins: comprehensive database on statin spending

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Main Anatomical Group, Therapeutic Subgroup, Pharmacological Subgroup, Chemical Subgroup, Chemical Subgroup, Pharmaceutical Specialty Identification Code, Top Generic, Generic Group, Age at the time of care, Sex, Region of Residence of the Beneficiary, Prescriber, Amount reimbursed, Refund Basis, Number of boxes delivered, Number of consumers (available only in NB_ type bases)

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2014 to 2021

Information/Contact for data request: The data is openly available.

Open Statins: additional bases on statin expenditure

Sponsor, manager or home institution: Caisse Nationale de l'Assurance Maladie (CNAM)

Type of information: Main Anatomical Group, Therapeutic Subgroup, Pharmacological Subgroup, Chemical Subgroup, Chemical Subgroup, Pharmaceutical Specialty Identification Code, Top Generic, Generic Group, Age at the time of care, Sex, Region of Residence of the Beneficiary, Prescriber, Amount reimbursed, Refund Basis, Number of boxes delivered, Number of consumers (available only in NB_ type bases)

Source of Information: Système National des Données de Santé (SNDS)

Data level: Patient level.

Date Range: 2014 to 2021

Information/Contact for data request: The data is openly available.

Registries

Death registry (CepiDC)

Data availability: Partial open data